As many as one million Americans currently live with Parkinson's disease with approximately 60,000 more Americans diagnosed each year, not including thousands more that likely go undetected. Parkinson's disease is a neurodegenerative disorder often considered to be caused by a deficiency of dopamine in the basal ganglia circuit which leads to motor deficits. Kinesia paradoxa is a phenomenon most often seen in people with Parkinson's disease and although symptoms of Parkinson's disease are varied, one of the most affected motor characteristics is gait disturbance.
Festinating gait (also known as Parkinsonian gait) is characterized by a quickening and shortening of normal strides. Festinating gait can be disruptive for an individual diagnosed with Parkinson's disease and may interfere with the individual's ability to work and engage in daily activities. Furthermore, festinating gait can typically lead to accelerating gait which can result in an individual falling over and potentially causing injury.
One common symptom that affects roughly 50% of people in the advanced stages of the disease is referred to as Freezing of Gait (FOG). FOG is typically a transient episode that lasts less than a minute. During a FOG episode, gait halts with patients describing the situation as having his/her feet glued to the ground; when the patient overcomes the block, walking normally resumes.
Many Parkinson's patients use some form of wheeled walker (also known as a rolling walker or rollator) for mobility. Wheeled walkers may provide additional needed stability and are available in various configurations which can include a seat rest and hand brake(s,) and some can be equipped with optional sensory (visual/audio) cueing as described, for example, by Miller (U.S. Pat. Nos. 5,538,268 and 7,484,740). During a FOG episode, an individual using a wheeled walker with visual/audio cueing may press a button to display a laser line to step over and hear a series of metronome clicking to assist in overcoming the FOG episode. The visual/audio cueing has not really changed much since it was first adapted to wheeled walkers.
Of peripheral relation, U.S. Pat. Appln. Publ. No. 20130171598 and U.S. Pat. No. 8,961,186 (LoSasso) describe a system for improving movement in a user with impaired gait. The system includes a flexible front cross bar removably attached to a walker, and a first indicator attached to the front cross bar and having an indicator including electronic circuitry, a first light, and a first sensor. The first indicator provides a first visual cue. A second indicator is attached to the front cross bar and includes electronic circuitry, a second light, and a second sensor. The second indicator provides a second visual cue, which in combination with the first visual cue, instruct the user to move his or her legs in a particular order to improve a walking gait of the user.
Figures in LoSasso show the invention in use, for example, a relatively able-bodied individual using the walker for rehabilitation purposes. In addition to the first and second visual cues, such as a green glow of a ball that flutters and shimmers, auditory cues may also be provided, such as a pleasing and rewarding tone, only when one of the sensors is triggered. A controller enables transmission of data about the user's movement history, and also enables the visual and auditory cue settings to be controlled. LoSasso does not, however, enable remote control of the indicators.
Selod (U.S. Pat. Appln. Publ. No. 20060292533) describes a gait training system including an ambulation assist device such as a walker, and a target projection device (light source) attached to the walker which directs light to form a guide target in the path of the feet of the user. The user is able to select a number of light sources and a number of guide targets. Aural or tactile stimuli may be provided to accompany the guide target, e.g., a sound emitted from a speaker when the user steps on the guide target or a tactile stimulation provided by a vibrating handgrip.
Hu et al. (U.S. Pat. No. 8,702,567) describes a system for improving a user's movement and includes an assistive walking device having a frame that supports the user moving by foot across a walking surface, a first distance sensor attached to the frame and that determines a distance from an object crossing a line to the distance sensor, and a processor that determine characteristics of a gait the user based on the determined distance data. More specifically, the system of Hu et al. includes a first distance detector proximal to the user and the second distance sensor distal from the user and that are located orthogonally to the user on the side structure of the walker. During use, the user breaks the plane of the detector thereby rendering a sensing of user movement. Hu et al. does not enable remote control of the user-set characteristics of the system.
None of these references disclose remote initiation of visual/audio cueing, nor address safety when using a laser. None of these references disclose a system that is capable of adapting to changing gait through software. Moreover, audio is used as a form of feedback rather than as a prompt.